胸髄髄内発生と考えられた神経腸嚢胞の1例
胸髄髄内発生と考えられた神経腸嚢胞の1手術例を報告する.症例は7歳の男児.比較的急速に進行する痙性対麻痺を呈した.脊髄MRIでTh1/2レベルの髄内に局在する嚢胞性病変を認めた.初回治療として嚢胞壁開窓術を行い,神経腸嚢胞の病理診断を得た.術後2週間で再発を認め,追加治療として嚢胞-くも膜下腔シャント術を施行したところ,嚢胞の消失と症状の改善が得られた.神経腸嚢胞は,脊索と前腸の不完全な分離により生じるまれな先天疾患で,脊髄髄内発生は非常にまれとされる.その外科的治療について過去の報告をレビューし,治療方針について若干の考察を行う....
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| Published in | 脳神経外科ジャーナル Vol. 21; no. 8; pp. 631 - 636 |
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| Main Authors | , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
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日本脳神経外科コングレス
20.08.2012
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| Online Access | Get full text |
| ISSN | 0917-950X 2187-3100 |
| DOI | 10.7887/jcns.21.631 |
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| Abstract | 胸髄髄内発生と考えられた神経腸嚢胞の1手術例を報告する.症例は7歳の男児.比較的急速に進行する痙性対麻痺を呈した.脊髄MRIでTh1/2レベルの髄内に局在する嚢胞性病変を認めた.初回治療として嚢胞壁開窓術を行い,神経腸嚢胞の病理診断を得た.術後2週間で再発を認め,追加治療として嚢胞-くも膜下腔シャント術を施行したところ,嚢胞の消失と症状の改善が得られた.神経腸嚢胞は,脊索と前腸の不完全な分離により生じるまれな先天疾患で,脊髄髄内発生は非常にまれとされる.その外科的治療について過去の報告をレビューし,治療方針について若干の考察を行う. |
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| AbstractList | 胸髄髄内発生と考えられた神経腸嚢胞の1手術例を報告する.症例は7歳の男児.比較的急速に進行する痙性対麻痺を呈した.脊髄MRIでTh1/2レベルの髄内に局在する嚢胞性病変を認めた.初回治療として嚢胞壁開窓術を行い,神経腸嚢胞の病理診断を得た.術後2週間で再発を認め,追加治療として嚢胞-くも膜下腔シャント術を施行したところ,嚢胞の消失と症状の改善が得られた.神経腸嚢胞は,脊索と前腸の不完全な分離により生じるまれな先天疾患で,脊髄髄内発生は非常にまれとされる.その外科的治療について過去の報告をレビューし,治療方針について若干の考察を行う. |
| Author | 鳴海, 治 佐野, 徳隆 半田, 明 奥, 圭佑 吉本, 修也 黒山, 貴弘 西, 秀久 佐藤, 宰 小柳, 正臣 黒崎, 義隆 定政, 信猛 山形, 専 永田, 学 鳥橋, 孝一 |
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| References | 8) FORTUNA A. Intradural spinal cysts. Acta Neurochir (Wien). (1983) vol.68, p.289-314. 31) 武美寛治. Cervical intramedullary neurenteric cyst の一例. No Shinkei Geka. (1984) vol.12, p.539-543. http://search.jamas.or.jp/link/ui/1984163401 9) GRAG N. Is total excision of spinal neurenteric cysts possible?. Br J Neurosurg. (2008) vol.22, p.241-251. 19) PALMA L. Spinal endodermal cysts without associated vertebral or other congenital abnormalities. Acta Neurochir (Wien). (1976) vol.33, p.283-300. 2) AGRAWAL D. Intramedullary neurenteric cyst presenting as infantile paraplegia : a case and review. Pediatr Neurosurg. (2002) vol.37, p.93-96. 12) KUMAR R. Unusal neuroenteric cysts : Diagnosis and management. Pediatr Neurosurg. (2002) vol.37, p.321-330. 23) ROTONDO M. Intramedullary neurenteric cysts of the spine. Report of three cases. J Neurosurg Spine. (2005) vol.2, p.372-376. 24) SINGHAL BS. Intramedullary neurenteric cyst in mid thoracic spine in an adult : A case report. Neurol India. (2001) vol.49, p.302-304. 15) MENEZES AH. Craniocervical intradural neurenteric cysts. Pediatr Neurosurg. (1995) vol.22, p.88-95. 29) ZIU M. Isolated spinal neurenteric cyst presenting as intramedullary calcified cystic mass on imaging studies : case report and review of literature. Neuroradiology. (2010) vol.52, p.119-123. 6) Case records of the Massachusetts General Hospital. Case 46122. N Engl J Med. (1960) vol.262, p.623-627. 26) THERET E. Huge intramedullar neurenteric cyst with intrathoracic development in a 1 month-old boy : Excision through the anterior approach. A case report and review of the literature. Acta Neurochir. (2010) vol.152, p.481-483. 11) KUBIE LS. A clinical and pathological study of two teratomatous cysts of the spinal cord, containing mucus and ciliated cells. Surg Gynec Obstet. (1928) vol.47, p.297-311. 21) REWCASTLE NB. Teratomatous cysts of the spinal canal with 'sex chromation' studies. Arch Neurol. (1964) vol.2, p.91-99. 4) ARAI Y. Spinal neurenteric cyst : Report of two cases and review of forty-one cases reported in Japan. Spine. (1992) vol.17, p.1421-1424. 5) CAI C. Intraspinal neurenteric cysts in children. Can J Neurol Sci. (2008) vol.35, p.609-615. 1) ABHISHEK A. Extreme lateral approach in a case of acute-onset quadriplegia due to high cervical neurenteric cyst. Pediatr Neurosurg. (2007) vol.43, p.134-136. 25) TAKAHASHI S. Percutaneous transthoracic fenestration of an intramedullary neurenteric cyst in the thoracic spine with intraoperative magnetic resonance image navigation and thoracoscopy. J Neurosurg Spine. (2008) vol.9, p.488-492. 28) VEEKLAS GMH. Pathogenesis of intrathoracic gastrogenic cysts. Am J Dis Child. (1952) vol.83, p.500-507. 18) NAGI S. Intramedullary neurenteric cyst without concurrent malformation. Australas Radiol. (2007) vol.51, p.B14-B17. 3) AOKI S. Enterogenous cyst of cervical spine : clinical and radiological aspects (including CT and MRI). Neuroradiology. (1987) vol.29, p.291-293. 20) REINDERS J. Intramedullary enterogenous cyst presenting with spastic paraparesis during two consecutive pregnancies ; A case report. J Neurol Neurosurg Psychiatry. (2001) vol.71, p.528-530. 7) DE OLIVEIRA RS. Neurenteric cysts in children : 16 consecutive cases and review of the literature. J Neurosurg. (2005) vol.103, p.512-523. 27) TUBBS R. Neurenteric csyt ; Case report and a review of the potential dysembryology. Clinical Anatomy. (2006) vol.19, p.669-672. 10) HICDONMEZ T. Spontaneous hemorrhage into spinal neurenteric cyst. Childs Nerv Syst. (2004) vol.20, p.438-442. 22) RIVIEREZ M. Intramedullary neurenteric cyst without any associated malformation : One case evaluated by MRI and electron microscopic study. Acta Neurochir (Wien). (1997) vol.139, p.887-890. 13) LANGMAN J. Medical embryology ; Human development, normal and abnormal. Williams and Wilkins. (1969 30) KON Takashi. el al. Severe Tension Pneumocephalus Caused by Opening of the Frontal Sinus by Head Injury 7 Years After Initial Craniotomy : Case Report. 神経外科. The Japan Neurosurgical Society. (2003) vol.43, no.5, p.242-245. http://search.jamas.or.jp/link/ui/2003261141, doi:10.2176/nmc.43.242 14) LIPPMAN CR. Intramedullary neurenteric cysts of the spine. Case report and review of the literature. J Neurosurg. (2001) vol.94, p.305-309. 17) MUZUMDAR D. Intramedullary cervical neurenteric cyst mimicking an abscess. Pediatr Neurosurg. (2008) vol.44, p.55-61. 16) MENEZES AH. Spinal neurenteric cysts in the magnetic resonance imaging era. Neurosurgery. (2006) vol.58, p.97-105. |
| References_xml | – reference: 10) HICDONMEZ T. Spontaneous hemorrhage into spinal neurenteric cyst. Childs Nerv Syst. (2004) vol.20, p.438-442. – reference: 15) MENEZES AH. Craniocervical intradural neurenteric cysts. Pediatr Neurosurg. (1995) vol.22, p.88-95. – reference: 23) ROTONDO M. Intramedullary neurenteric cysts of the spine. Report of three cases. J Neurosurg Spine. (2005) vol.2, p.372-376. – reference: 11) KUBIE LS. A clinical and pathological study of two teratomatous cysts of the spinal cord, containing mucus and ciliated cells. Surg Gynec Obstet. (1928) vol.47, p.297-311. – reference: 21) REWCASTLE NB. Teratomatous cysts of the spinal canal with 'sex chromation' studies. Arch Neurol. (1964) vol.2, p.91-99. – reference: 3) AOKI S. Enterogenous cyst of cervical spine : clinical and radiological aspects (including CT and MRI). Neuroradiology. (1987) vol.29, p.291-293. – reference: 25) TAKAHASHI S. Percutaneous transthoracic fenestration of an intramedullary neurenteric cyst in the thoracic spine with intraoperative magnetic resonance image navigation and thoracoscopy. J Neurosurg Spine. (2008) vol.9, p.488-492. – reference: 1) ABHISHEK A. Extreme lateral approach in a case of acute-onset quadriplegia due to high cervical neurenteric cyst. Pediatr Neurosurg. (2007) vol.43, p.134-136. – reference: 22) RIVIEREZ M. Intramedullary neurenteric cyst without any associated malformation : One case evaluated by MRI and electron microscopic study. Acta Neurochir (Wien). (1997) vol.139, p.887-890. – reference: 9) GRAG N. Is total excision of spinal neurenteric cysts possible?. Br J Neurosurg. (2008) vol.22, p.241-251. – reference: 17) MUZUMDAR D. Intramedullary cervical neurenteric cyst mimicking an abscess. Pediatr Neurosurg. (2008) vol.44, p.55-61. – reference: 2) AGRAWAL D. Intramedullary neurenteric cyst presenting as infantile paraplegia : a case and review. Pediatr Neurosurg. (2002) vol.37, p.93-96. – reference: 13) LANGMAN J. Medical embryology ; Human development, normal and abnormal. Williams and Wilkins. (1969) – reference: 30) KON Takashi. el al. Severe Tension Pneumocephalus Caused by Opening of the Frontal Sinus by Head Injury 7 Years After Initial Craniotomy : Case Report. 神経外科. The Japan Neurosurgical Society. (2003) vol.43, no.5, p.242-245. http://search.jamas.or.jp/link/ui/2003261141, doi:10.2176/nmc.43.242 – reference: 18) NAGI S. Intramedullary neurenteric cyst without concurrent malformation. Australas Radiol. (2007) vol.51, p.B14-B17. – reference: 28) VEEKLAS GMH. Pathogenesis of intrathoracic gastrogenic cysts. Am J Dis Child. (1952) vol.83, p.500-507. – reference: 26) THERET E. Huge intramedullar neurenteric cyst with intrathoracic development in a 1 month-old boy : Excision through the anterior approach. A case report and review of the literature. Acta Neurochir. (2010) vol.152, p.481-483. – reference: 4) ARAI Y. Spinal neurenteric cyst : Report of two cases and review of forty-one cases reported in Japan. Spine. (1992) vol.17, p.1421-1424. – reference: 12) KUMAR R. Unusal neuroenteric cysts : Diagnosis and management. Pediatr Neurosurg. (2002) vol.37, p.321-330. – reference: 20) REINDERS J. Intramedullary enterogenous cyst presenting with spastic paraparesis during two consecutive pregnancies ; A case report. J Neurol Neurosurg Psychiatry. (2001) vol.71, p.528-530. – reference: 27) TUBBS R. Neurenteric csyt ; Case report and a review of the potential dysembryology. Clinical Anatomy. (2006) vol.19, p.669-672. – reference: 8) FORTUNA A. Intradural spinal cysts. Acta Neurochir (Wien). (1983) vol.68, p.289-314. – reference: 29) ZIU M. Isolated spinal neurenteric cyst presenting as intramedullary calcified cystic mass on imaging studies : case report and review of literature. Neuroradiology. (2010) vol.52, p.119-123. – reference: 16) MENEZES AH. Spinal neurenteric cysts in the magnetic resonance imaging era. Neurosurgery. (2006) vol.58, p.97-105. – reference: 14) LIPPMAN CR. Intramedullary neurenteric cysts of the spine. Case report and review of the literature. J Neurosurg. (2001) vol.94, p.305-309. – reference: 7) DE OLIVEIRA RS. Neurenteric cysts in children : 16 consecutive cases and review of the literature. J Neurosurg. (2005) vol.103, p.512-523. – reference: 19) PALMA L. Spinal endodermal cysts without associated vertebral or other congenital abnormalities. Acta Neurochir (Wien). (1976) vol.33, p.283-300. – reference: 24) SINGHAL BS. Intramedullary neurenteric cyst in mid thoracic spine in an adult : A case report. Neurol India. (2001) vol.49, p.302-304. – reference: 31) 武美寛治. Cervical intramedullary neurenteric cyst の一例. No Shinkei Geka. (1984) vol.12, p.539-543. http://search.jamas.or.jp/link/ui/1984163401 – reference: 5) CAI C. Intraspinal neurenteric cysts in children. Can J Neurol Sci. (2008) vol.35, p.609-615. – reference: 6) Case records of the Massachusetts General Hospital. Case 46122. N Engl J Med. (1960) vol.262, p.623-627. |
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